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Larry Liedke
Addiction (Substance Use Disorder) Counselor in Wauchula, Florida
NPI 1043614977

Larry Liedke is an Addiction (Substance Use Disorder) Counselor based in Wauchula, FL and is specialized in Addiction (Substance Use Disorder). Larry Liedke practices in Wauchula, FL. The NPI Number for Larry Liedke is 1043614977 and holds a License No. (Florida).

The current practice location address for Larry Liedke is 125 W Main St, Wauchula, FL and can be reached out via phone at 863-448-4332.

Location: 125 W Main St, Wauchula, FL, 33873-2819
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1043614977
Provider Name
Larry Liedke
Credential
Provider Entity Type
Individual
Gender
Male
Address
125 W Main St, Wauchula, FL, 33873-2819
Phone Number
863-448-4332
Fax Number
Provider Enumeration Date
10/21/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
125 W Main St
City
Wauchula
State
Florida
Zip
33873-2819
Phone Number
863-448-4332
Fax Number
person
Provider Business Mailing Address Details
Address
125 W Main St
City
Wauchula
State
Florida
Zip
33873-2819
Phone Number
863-448-4332
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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